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Application for Permit to Install Alarm System

Location of System

Installer Information

Contact Information

List two (2) people who can be contacted to respond to the property where the alarm is located 24 hours a day, 7 days a week.

The applicant agrees that if a person to be notified either refuses to come to premises upon request of the Town Police Department or cannot be reached within a reasonable time by telephone or otherwise, the Town Police may, without any liability for any charges as a result of disconnection, or any liability as a result of responding to alarms, do either of the following: disconnect the system itself, if possible, or contact the installer to disconnect the system.

Signature is required.
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Approved by: _________________________________

Date: ____/____/____